The use of glucocorticoids in the treatment of cerebral edema for glioma tumour patients: Pro and Contra

Abstract

Aim. To improve awareness of existing treatment regimens of cerebral edema by dexamethasone among doctors of various specialties (neurosurgeons, neurologists, intensive care specialists, endocrinologists). Based on scientific literature data the authors presented detailed descriptions of previously used and relevant now treatment regimens of cerebral edema by glucocorticoids (dexamethasone in particular). The authors estimated various dexamethasone prescribing schedules (2–64 mg doses fractionally used per day and one‑time 20 mg dose) for glioma tumor patients for understanding the effectiveness of therapy. The authors analyzed the risks of possible therapy by‑effects and complications. The risks were divided into the following groups: early (carbohydrate metabolic disorders, psychoemotional symptoms, hypertension, weight gain), later (exogenous hypercorticism, lipid metabolic disorders, proximal myopathy, osteoporosis, gastric and duodenal ulcer disease, immunosuppressive conditions) and withdrawal syndrome (adrenal insufficiency). In conclusion, the authors noted the ways to possibly prevent and reduce the side effects.